The Health Navigator engages frequently utilizing unhoused and medically needy adults in Emergency Departments to assess their needs and create individualized action plans to transition them to preventative primary care. This role involves coordinating referrals, securing community resources like shelter and benefits, and ensuring patients establish primary care providers post-discharge.
Requirements summary
A High School diploma or GED is required, along with two years of experience as a Medical Assistant, Case Manager, or Behavioral Health Technician, or equivalent education/experience, including direct patient care experience. Candidates must possess strong interpersonal and communication skills, computer proficiency, and a demonstrated interest in working with underserved populations.
Position: The Health Navigator is designed to work directly with and on behalf of indigent, unhoused, and uninsured patients who present frequently, and often for inappropriate healthcare needs, at local Emergency Departments with whom Circle the City has formal partnerships. The goal of the Health Navigator is to end the inappropriate overuse of emergency rooms and inpatient hospitalization by chronically unhoused individuals who are medically vulnerable and to assist them with their benefits, identification of a medical home at Circle the City and to work collaboratively with community partners for shelter, benefits, and housing assessment and placement. The Health Navigator is co-located within partner Emergency Departments and works with hospital clinical and social work staff to identify, screen, and refer these high-utilizing patients to more appropriate and less costly medical settings at CTC.
Essential
Duties:
Duties include, but are not limited to:
Outreach and
Consumer
Identification: Engage chronically unhoused/unsheltered, medically needy adults who are frequent users of hospital and emergency services annually.
Assessment and
Planning: Conduct patient screenings to evaluate social, mental health, and medical needs to create individualized action plans and move these patients from an emergency care model to a preventative primary care model.
Direct
Services and
Coordination: Build rapport and trusting relationships with patients. Collaborate with healthcare providers, social workers, and case managers to connect patients to appropriate resource services in their area and serve as a patient advocate. Coordinate referrals and transition of care into Circle the City's Medical Respite Centers when appropriate. Work directly with shelter services, substance use treatment programs, mental health programs, and other community partners to secure placement and enhance coordinated discharges. Assist the patient to complete applications for appropriate programs and services that address needs including but not limited to housing instability, food insecurity, substance use, and transportation services. Assist patients to establish a primary care provider and schedule post discharge appointments to ensure any barriers to care are addressed prior to discharge. Maintain a working knowledge of economic, educational, and social problems of individuals facing homelessness and referral sources available preferred. Monitoring, evaluation and follow-up, advocacy and collaboration include Participate in multi-disciplinary team meetings as needed to coordinate patient services and review accomplishments. Document and track assessments and outcomes including encounters, contact attempts and action plans. Collect and report data to Circle the City leadership and hospital partners. All other duties as assigned. Possess and maintain a valid Arizona driver’s license.
QualificationsQualifications:
Basic
Knowledge and
Skills: A bachelor's degree in health-related field is preferred but not required. The position requires a High School diploma or GED and 2 years of experience as a Medical Assistant (MA), Case Manager, Behavioral Health Technician (BHT), etc. OR equivalent combination of experience and education. Must have direct patient care experience. Requires strong interpersonal skills with the ability to professionally communicate with health professionals at all levels, managers, supervisors, vendors, and patients. Must be proficient in computer skills including Microsoft Outlook, Word and Excel. Demonstrate excellent written and oral communication skills. Demonstrated interest in working with an underserved population. Excellent customer service skills. Experience in working with culturally diverse, chronically unhoused, and medically needy individuals preferred. Must demonstrate critical thinking, problem-solving and organizational and time management skills. Must be able to work well with others in a team approach. Must be at least 21 years of age. Possess and maintain a valid Arizona driver’s license. Must have a working knowledge of care management, community resources and resource/utilization management. Bilingual-Spanish desired.
Physical and
Mental
Requirements: Able to obtain Community Health Worker (CHW) certificate (we can assist) Position requires extended periods of sitting and standing. Position requires regular bending and reaching, including transfer of patients. We are an equal-opportunity employer. All resumes will be reviewed for education and experience. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status.
